Principi: Eligibility explosion behind a VA claims
backlog

July 3, 2013

By Tom Philpott

Those criticizing the Department of
Veteran Affairs for its enormous backlog of disability claims are
ignoring how recent laws and politics have turned VA into something
Lincoln never envisioned: A fount of billions of dollars in payments for
ailments likely caused by aging rather than military service, says
former VA Secretary Anthony J. Principi.

Principi’s push to
restore"integrity"to the VA claims system began with a
keynote address June 20 at a Washington D. C. forum on the VA. His
speech, however, landed with a thud, ignored by other forum participants
and even by its co-hosts, a group called Concerned Veterans for America
and the conservative magazine The Weekly Standard.

The compensation claims backlog
can’t be solved, Principi argued, until Congress, VA leaders
and veteran service organizations acknowledge and address how recent
laws and policy decisions vastly expanded disability pay eligibility.
Unless a"rebalancing"of priorities occurs, the former VA chief
warned, public confidence in the VA claims system is at risk.

He compared calls by politicians and
pundits for current VA Secretary Eric Shinseki and key deputies to
resign over the claims backlog to"relieving the
lighthouse keeper because the fog is so thick no one can see the
light."

Ironically, Principi’s
remarks were sandwiched between a half hour of fresh attacks on the VA
from Republicans on the veterans affairs committees, and a panel of vet
advocates who urged VA to work harder and smarter to process the rising
river of claims. Overlooked was Principi’s assertion
that disability pay eligibility today goes far beyond
Lincoln’s charge:"To care for him who
shall have borne the battle and for his widow and his
orphan."

Disability claims of 50,000 veterans
wounded in Iraq and Afghanistan are not what’s"choking the VA benefits system,"Principi
said."They are the victims of the sclerosis now overwhelming
the VA benefits program."

Eighty percent of the more than one
million claims being filed annually are from veterans whose service time
predates 2001, said Principi. A decorated Vietnam War veteran and
President George W. Bush’s first VA
secretary, Principi noted that today"a veteran who spent
just one day in Vietnam will be automatically service-connected for Type
II diabetes, Parkinson’s disease,
prostate cancer, lung cancer and ischemic heart disease…the
most common effects of aging in American men."

Forty years after the Vietnam War
ended, 37 percent of VA claims are filed by"my fellow Vietnam
veterans -- almost double the number filed by recently discharged
veterans,"Principi said. Eleven percent–more than
100,000 claims–are filed by vets who never served in a time of
conflict.

The river of Vietnam-era claims grew
wider because of decisions VA secretaries have made to add common
ailments of aging, like Type II diabetes and ischemic heart disease, to
the list of conditions VA presumes are caused by long-ago exposure to
Agent Orange defoliants used in the war.

Yet studies from the Institute of
Medicine, on which key presumptive disease decisions are based, found
only"limited or suggestive evidence"of an association
with Agent Orange exposure, Principi noted.

As VA secretary in 2001, Principi told
me, he faced the difficult choice of finalizing a regulation drafted by
the Clinton administration to make Type II diabetes compensable for
Vietnam veterans or"have the first major veterans' decision of the
incoming Bush administration be to take away a major benefit offered by
Clinton."He signed the regulation.

"I
struggled with that decision and do so to this day,"Principi
said.

Current Secretary Shinseki opened the
Agent Orange claims floodgate farther when, again based on"limited or
suggestive evidence"of an association with Agent Orange, he added
heart disease and two other ailments to the presumptive disease list. If
claimants with these ailments can show they set foot in Vietnam during
the conflict, the ailments are deemed service-connected and eligible for
VA compensation.

Another factor in the flood of claims
is that"no claim is ever final,"Principi
said."All claims can be reopened and reopened -- and many
are."

As a Vietnam veteran, Principi
said,"I will be able to file a claim for prostate cancer, heart
disease or any of the other named diseases if I get sick at age 92 or
102. If any of those diseases contribute to my death, at any age, my
widow will get the same compensation as the surviving spouse of a
service member killed in Afghanistan…You
don’t have to be Einstein to predict the effect of this on
backlogs and timeliness."

The price of allowing vets to file
claims throughout their lives"is paid by the
veteran who has lost a leg to a mine; whose ability to think clearly was
clouded by an improvised explosive device; or by the grieving widow of a
newly deceased young corporal,"Principi
said."Their claims for compensation fend for themselves in an
environment where every veteran is first priority -- which
means, of course, that no veteran is first priority. When
everyone applies for disability compensation, those who represent the
reason VA exists must lose. They become part of the pack, their claims
just one more folder in an ever-higher pile."

VA data help make his case. In 2005, VA
paid $26.6 billion in disability compensation. This year it will pay out
$60.2 billion.

Principi isn’t calling for
current payments to be cut or stopped. He proposes more modest
reforms"to restore the trust of the American people in the VA
disability compensation system."He wants future
disability awards aimed at VA’s"core
mission"and not dispersed"to remedy every
problem imaginable for every veteran."

He proposes a cut-off date, either of
age or years since Vietnam service, for Agent-Orange-related
disabilities. Today the system"goes far beyond
resolving doubt in favor of the veteran, as VA is required to do. It
makes no sense when older veterans, long removed from their service, are
compensated for the expected and ordinary effects of aging."

He also criticized how the concept
of"individual unemployability"requires VA to
compensate vets as though 100-percent disabled if their lesser-rated
ailment prevents their working -- even at age 80 or 90.

If vet advocates won’t
embrace reasonable reforms, he warned,"we well may face
the prospect of reform with a timber ax, rather than a
scalpel."